title: Lymphoscintigraphy in clinical routine practice: reproducibility and accuracy in melanoma patients with a long-term follow-up.
abstract: BACKGROUND
  The sentinel node status is the most important single factor determining overall survival for patients with localized melanoma. Preoperative lymphoscintigraphy (LS) is essential in locating the correct sentinel lymph node (SN) and the reproducibility of the method determines the accuracy of the sentinel node biopsy (SNB). This study aims at determining the reproducibility and accuracy of LS in routine clinical practice after long-term follow-up.
  
  
  METHODS
  One hundred and eight melanoma patients with clinically unpredictable lymphatic drainage were prospectively enrolled to undergo two LS. The first LS was performed to determine the site and number of the lymphatic basins to plan SNB anesthesia and the second preoperative LS was to allow SN localization intra-operatively.
  
  
  RESULTS
  Lymphatic drainage was demonstrated in all patients. In 84 of 108 cases, both LSs were concordant in terms of site and number of nodal basins visualized. After a median follow-up of 80 months, no nodal recurrence was observed in the five patients with a decreased number of lymph node basins. In the group with increased number of lymph node basins, one patient developed nodal metastases in the same regional lymph node basin visualized by both LS studies.
  
  
  CONCLUSIONS
  LS is an accurate and reproducible method to determine the localization of the sentinel node in the day-to-day routine to clinical practice when primary melanoma is also located in body sites with variable lymphatic drainage.
authors.affiliation: Division of Melanoma and Soft Tissue Sarcoma, European Institute of Oncology, Via Ripamonti 435, Milan, Italy. Electronic address: giulio.vitali@ieo.it.
authors.forename: G C
authors.initials: GC
authors.lastname: Vitali
authors.affiliation: Nuclear Medicine Unit, Fondazione Salvatore Maugeri, Via S. Maugeri 4, Pavia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Trifirò
authors.affiliation: Surgical Division, Mater Medical Centre, 21-37 Fulham Road, Townsville, Australia.
authors.forename: M
authors.initials: M
authors.lastname: Zonta
authors.affiliation: Division of Melanoma and Soft Tissue Sarcoma, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Pennacchioli
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Santoro
authors.affiliation: Division of Nuclear Medicine, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: L L
authors.initials: LL
authors.lastname: Travaini
authors.affiliation: Division of Pathology and Laboratory Medicine, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Barberis
authors.affiliation: Division of Melanoma and Soft Tissue Sarcoma, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Testori
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D061305:Lymphoscintigraphy; D008297:Male; D008545:Melanoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D015203:Reproducibility of Results; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery
keywords: Clinical routine practice; Lymphoscintigraphy; Melanoma; Reproducibility; Sentinel lymph node